Herpes zoster keratitis development after acute retinal necrosis

Ansari, Waseem; Pichi, Francesco; Pecen, Paula E.; Lowder, Careen Y.; Srivistava, Sunil

doi:10.1007/s10792-017-0521-7

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…Immunohistochemistry was negative for HSV, suggesting that the orbital findings are part of a reactionary inflammatory response. There has been some discussion that ARN may represent a reactivation of a herpetic virus from the ciliary ganglion, 12 , 13 which lies in close proximity to the globe; reactivation of the virus there could serve as the nidus for an orbital inflammatory reaction.…”

Section: Discussionmentioning

confidence: 99%

Concurrent acute retinal necrosis and orbital inflammation: Report of 2 cases

Swaminathan

Yannuzzi

Rong

et al. 2019

American Journal of Ophthalmology Case Reports

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Purpose To describe the rare entity of concurrent herpetic acute retinal necrosis (ARN) and orbital inflammation. Observations Two cases of ARN with simultaneous orbital inflammation are described. A 40-year old male presented with a painful left eye and hand motion visual acuity (VA). Both panuveitis and orbital inflammation with involvement of the sclera and optic nerve were observed. He was initially treated with oral steroid therapy, after which the orbital inflammation improved but the panuveitis remained. A diagnostic anterior chamber paracentesis was positive for HSV-2 by PCR. He was started on systemic antivirals, but ultimately developed a retinal detachment. The second patient was an 18-year old female with hand motion VA in the left eye. Panuveitis and severe conjunctival chemosis were observed. MRI demonstrated dacryoadenitis with preseptal inflammation. The patient was initially started on oral steroid therapy, which alleviated the orbital inflammation but not the intraocular inflammation. An anterior chamber diagnostic paracentesis was positive for HSV-1, after which the patient underwent vitrectomy for a retinal detachment. The patient was started on systemic antiviral therapy. Conclusions and Importance Herpetic disease should remain on the differential for cases of concurrent intraocular and orbital inflammation. Early recognition of this process may help prevent severe vision loss. It is important to recognize that orbital inflammation secondary to herpetic disease may be diverse in its presentation.

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Section: Discussionmentioning

confidence: 99%

Concurrent acute retinal necrosis and orbital inflammation: Report of 2 cases

Swaminathan

Yannuzzi

Rong

et al. 2019

American Journal of Ophthalmology Case Reports

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“…Dong et al [ 91 ], identified trauma to be the main cause of infectious keratitis in their study[ 91 ]. HSK may also complicate the course of acute retinal necrosis in 20% of sufferers[ 92 - 93 ].…”

Section: Understanding the Pathogenesis Of Herpes Simplex Keratitismentioning

confidence: 99%

Herpes simplex keratitis: A brief clinical overview

Musa,

Enaholo,

Aluyi-Osa

et al. 2024

World J Virol

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The aim of our minireview is to provide a brief overview of the diagnosis, clinical aspects, treatment options, management, and current literature available regarding herpes simplex keratitis (HSK). This type of corneal viral infection is caused by the herpes simplex virus (HSV), which can affect several tissues, including the cornea. One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea. After the initial infection, the HSV can establish a latent infection in the trigeminal ganglion, a nerve cluster near the eye. The virus may remain dormant for extended periods. Periodic reactivation of the virus can occur, leading to recurrent episodes of HSK. Factors triggering reactivation include stress, illness, immunosuppression, or trauma. Recurrent episodes can manifest in different clinical patterns, ranging from mild epithelial involvement to more severe stromal or endothelial disease. The severity and frequency of recurrences vary among individuals. Severe cases of HSK, especially those involving the stroma and leading to scarring, can result in vision impairment or even blindness in extreme cases. The cornea's clarity is crucial for good vision, and scarring can compromise this, potentially leading to visual impairment. The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization. Antiviral medications, such as oral Acyclovir or topical Ganciclovir, may be prescribed for prophylaxis. The immune response to the virus can contribute to corneal damage. Inflammation, caused by the body's attempt to control the infection, may inadvertently harm the corneal tissues. Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation. In summary, the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.

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